Melanoma Treatments | MedStar Health

We'll customize a melanoma treatment plan that will lead to your best outcome and quality of life.

We offer a full range of effective treatments for melanoma. Surgery is often an effective skin cancer treatment for early-stage melanomas, but more advanced cancers often require other approaches. Sometimes more than one treatment type is needed.

Options depend on:

  • The melanoma’s thickness, stage, rate of growth, and any genetic changes

  • Whether it has spread

  • Possible side effects

  • Your overall health

  • Your preferences

Surgery

Many melanomas are cut from the skin quickly and easily, with no further treatment needed — in fact, many times the disease is removed during the initial biopsy. If surgery is needed, our expert doctors provide several types:

  • Wide local excision: Excision is our standard approach, removing the cancer and up to two centimeters of surrounding tissue, with the amount and the degree of scarring dependent on the tumor’s thickness

  • Mohs micrographic surgery: During Mohs surgery, the cancer is shaved off one thin layer at a time and checked under a microscope. Such a procedure is helpful when the tumor:

    • Has an unknown shape and depth

    • Is large

    • Has returned

    • Is located in a hard-to-treat spot, especially in the head and neck

    • Only doctors who are specially trained should perform Mohs surgeries, and we offer this expertise.

  • Sentinel lymph node mapping and biopsy: In some cases, our doctors may recommend a sentinel lymph node biopsy with lymphatic mapping (lymphoscintigraphy) before surgery. During this minimally invasive procedure, the doctor injects a dye and a (safe) radioactive substance at the site of the cancer, then watches to see which lymph node it migrates to first—the sentinel lymph node.

    Then, we biopsy that lymph node. If there is no cancer in the lymph node, we don't need to do anything else with it. If it is not clear, we may need to remove one or more lymph nodes, a surgery called dissection or lymphadenectomy.

Reconstruction and grafting

Sometimes melanoma is located in a cosmetically sensitive area or the doctor has to remove a large amount of tissue. If that’s the case, your dermatologic oncologist will partner with one of our expert plastic surgeons when the surgery is still in the planning stage.

After the surgery, the plastic surgeon repairs any visible scars. For larger tumors, your doctor may reconstruct the surgical site with a skin graft, taken from a discreet place elsewhere on your body. Your team works hard to ensure you are happy with the final results.

Chemotherapy

Melanoma is often resistant to chemotherapy, and targeted therapy is usually a better choice when the disease has advanced. But chemotherapy can help relieve symptoms or extend survival for some patients, and it can also help save limbs in some cases.

Our doctors have the skill and experience needed for complex procedures that temporarily cut off circulation to an arm or leg, then deliver chemotherapy just to that limb. This treatment can save the limb and is often recommended when the melanoma has returned to that area, with a number of confined tumors that are untreatable with surgery. There are two approaches:

  • Hyperthermic Isolated Limb Perfusion (HILP): HILP involves surgery and heats the chemotherapy’s route to make it more susceptible to the drug.
  • Isolated Limb Infusion (ILI): ILI is not a surgery but a minimally invasive procedure that uses catheters threaded through a small incision into veins and arteries. The procedure is shorter and easier on frail and elderly patients and in cases where a patient might need more than one treatment.

Both approaches provide advantages when compared to delivering systemic chemotherapy throughout the body:

  • Higher doses than could otherwise be given
  • More effective in such cases
  • Avoid amputation

We continue to explore new chemotherapy options in clinical trials, including the possibility of identifying each melanoma’s particular resistance and susceptibility.

Immunotherapy and targeted therapy

Our doctors are pioneers in immunotherapy and targeted therapy, which are innovative approaches to treating this type of skin cancer. These therapies fight the cancer by focusing on specific genetic changes that help the disease grow.

Sometimes these therapies work when chemotherapy doesn’t, and sometimes the two treatments are paired together in a new approach called biochemotherapy. Targeted therapy represents a promising front for melanoma treatment, and many patients qualify for clinical trials that offer hope. Drugs that are already FDA-approved include those that:

  • Target Genetic Changes: Given as pills to shrink or slow growth in tumors with BRAF mutations or others

  • Help the Immune System: Given as an IV infusion or an injectable vaccine, immunotherapy boosts the immune system or removes proteins that normally keep it in check

Your specialized team will help you understand the benefits and risks of each of your options, including any possible side effects. Together, you'll weigh the pros and cons with the goal of getting rid of the cancer while preserving your quality of life.

Radiation therapy

If melanoma cannot be removed with surgery or it has spread to other parts of the body, like the brain or bones, your treatment may involve radiation therapy. It may also be used for melanomas located in a place that’s hard to treat with surgery, such as the eyelids, tip of the nose, or ears. The decision will be made by your multidisciplinary team that includes a radiation oncologist with expertise in using high-energy rays to stop cancer cells from growing.

When radiation is part of your treatment plan, you can expect us to administer it using the right dose and the right technology to minimize side effects while leading to the best outcomes. The type of radiation we recommend will depend on the size and location of your tumor, as we want to limit the amount of radiation to critical organs and structures in the body. We have access to all of the latest melanoma radiation therapies, including:

  • External beam radiation therapy: External beam radiation uses a large machine to aim high-energy radiation beams at your cancer from outside your body. Our specialists treat as small an area as possible to avoid causing unnecessary damage to your healthy tissue. One of the ways we do this is through Intensity-Modulated Radiation Therapy, or IMRT.
  • Proton beam therapy: This advanced radiation may be used when the cancer has spread to the brain or other critical structures. It works by pinpointing a tumor's exact location, destroying the tumor layer-by-layer.
  • Stereotactic Radiosurgery (SRS), or CyberKnife: This type of radiation requires only a single treatment when melanoma has spread to the brain, spine, or other part of the body. Because it's highly precise, it's an effective option that limits radiation to healthy tissue.

Looking for expert cancer care?

With multiple locations throughout the region, patients have access to many of the nation’s renowned cancer specialists offering high quality care, second opinions and a chance for better outcomes close to where they live and work. Georgetown Lombardi Comprehensive Cancer Center, one of the nation’s comprehensive cancer centers designated by the National Cancer Institute (NCI), serves as the research engine allowing patients access to clinical trials that often lead to breakthroughs in cancer care.

Our locations

Distance from Change locationEnter your location

MedStar Franklin Square Cancer Center at Loch Raven Campus

5601 Loch Raven Blvd.
Russell Morgan Building
First Floor
Baltimore, MD 21239

MedStar Georgetown Cancer Institute at MedStar Franklin Square Medical Center

9103 Franklin Square Dr.
The Harry and Jeanette Weinberg Cancer Institute
Suite 220
Baltimore, MD 21237

MedStar Georgetown Cancer Institute at MedStar St. Mary’s Hospital

25500 Point Lookout Rd.
First Fl.
Leonardtown, MD 20650

Why choose us

Every patient is reviewed in a weekly melanoma tumor board that gathers input from all of the right doctors from the beginning. It's important to get the right answers the first time, and that's what you can expect when you seek diagnosis and treatment at MedStar Health. Your care team involves several different specialists who combine their strengths and areas of expertise to design a personalized treatment plan that will be most effective in treating your specific melanoma. Here, you'll benefit from the knowledge and expertise of different specialists in:

  • Dermatology

  • Pathology

  • Medical oncology

  • Surgery

  • Radiation oncology

  • Rehabilitation

  • and more

Collectively, we've been treating patients with melanoma for decades, and we are equipped to care for patients of all stages and types, including those that are rare.

We treat patients with melanoma using academic medicine and clinical trials that are advancing how the disease is treated worldwide. Melanoma survival rates are significantly better than they were a decade ago, thanks to research. Our doctors are leaders in emerging treatments that are revolutionizing how this type of cancer is treated. We regularly recommend patients participate in clinical trials that offer access to new drugs or therapy combinations that can improve your treatment.

We offer world-class reconstruction and restoration to preserve your natural appearance and minimize scarring. For patients with cancer in a cosmetically sensitive area or when surgery involves removing a large area of skin, we'll work closely with MedStar Health's renowned reconstructive surgeons who are skilled at repairing and rebuilding areas of the body impacted by this cancer.

Awards and recognition

Recipient of an Accreditation with Commendation, the highest level of approval, from the American College of Surgeons' Commission on Cancer (CoC)

Numerous surgeons, medical oncologists, and surgical oncologists recognized as "Top Doctors" by both Baltimore Magazine and the Washingtonian

Magnet® designation from the American Nurses Credentialing Center (ANCC)

Clinical trials and research

Clinical trials

We use the latest research findings to care for patients and offer the most advanced cancer clinical trials available today, including immunotherapies that have significantly improved melanoma survival rates. You may be eligible for a melanoma clinical trial that offers promising results for you today and could help other people with this type of cancer in the future.

Research

Research plays an important part in cancer treatment. The treatments available today have been developed just in the past few years as a result of advanced studies. This includes melanoma treatments first offered in clinical trials that have become the standard approach and the backbone for new research studies. Many of these treatments offer better hope for a cure, and we continue investigating new, better ways to treat melanoma, including cases resistant to current therapies.

Patient stories

Support services

At MedStar Health, we're known for advanced melanoma care that extends beyond your medical needs. Here, our compassionate team strives to support your mind and spirit as you work through treatment and recovery. However you need us, we're here for you.

Learn More About Cancer Support Services

Genetic counseling

Genetic counseling can help individuals with melanoma and their families understand the hereditary and environmental risks associated with the disease. Our board-certified genetic counselors are experts in determining when genetic testing may be useful and recommend risk-management strategies, including more frequent skin cancer screenings, when appropriate.

Learn More About Genetic Counseling

Personalized rehabilitation

Treatment side effects can range from joint pain and decreased range of motion to lymphedema (chronic swelling) or fatigue, depending on your stage of cancer and whether or not you had surgery. Our physical and occupational therapists are experts in cancer rehabilitation and lymphedema prevention, and they'll develop an individualized plan to help you rebuild strength and minimize any lingering effects of treatment.

Learn More About Cancer Rehabilitation

Survivorship

As a melanoma survivor, your care continues even after you're cancer-free. We'll walk alongside you to minimize and treat any unwanted side effects that may be related to your cancer treatment, with the help of dietitians, counselors, rehabilitation experts, and other medical specialists. We'll also develop a personalized plan to help manage any risk of cancer recurrence through regular medical appointments and screenings.

Learn More About the Cancer Survivorship Program